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MED-TRANSFERPEXAMNOMINATION PDF 2017/10
Graduate and Postdoctoral Studies
TRANSFER EXAM (FAST-TRACK) EXAMINER NOMINATION
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STUDENT IDENTIFICATION
STUDENT NAME STUDENT NUMBER
NAME OF SUPERVISOR NAME OF CO-SUPERVISOR (IF APPLICABLE)
GRADUATE PROGRAM
MSc
PhD
BIOCHEMISTRY
CELLULAR AND MOLECULAR MEDICINE
EPIDEMIOLOGY
MICROBIOLOGY AND IMMUNOLOGY
NEUROSCIENCE
TO BE COMPLETED BY THE STUDENT AND/OR THE SUPERVISOR
PLEASE LIST ALL MEMBERS OF THE TRANSFER EXAM COMMITTEE
PRINT NAME PHONE NUMBER E-MAIL
PRINT NAME PHONE NUMBER E-MAIL
PRINT NAME PHONE NUMBER E-MAIL
SIGNATURES
SIGNATURE (SUPERVISOR) DATE (YYYY-MM-DD) SIGNATURE (CO-SUPERVISOR) (IF APPLICABLE) DATE (YYYY-MM-DD)
SIGNATURE (GRADUATE PROGRAM DIRECTOR) DATE (YYYY-MM-DD)
FOR INTERNAL USE
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